Access to the human heart, the thoracic cavity, the neck structures, the cervical spine and the dorsal spine has always been difficult and a source of active research, especially recently with the advancement in technology that has led to improved methods of minimally invasive surgery, orthopedic procedures and neurosurgical procedures. Heart disease is the leading cause of death connected to all age groups in the United States. The esophagus has a close proximity to the heart and the posterior mediastinum, which has allowed the use of transesophageal fine needle aspiration and transesophageal biopsy techniques to be used extensively in recent years to obtain tissue samples. Most of the posterior mediastinal tissues are accessible for biopsy by this route, including the lungs and lymph nodes. The technique has proven to be safe and reproducible with minimal complications. A discussion of such techniques and some of their key uses can be found in U.S. Pat. No. 6,689,062 and in related pending cases, which provide a full background describing this promising new technique. Other groups are also exploring transesophageal surgery, as described for example in WO 2007/149588. In exploring this new area of minimally invasive surgery, it has been found that one of the important but difficult details that need improvement is managing the passage of instruments across the esophageal wall. Surgery via the esophagus has numerous attractions for thoracic and cervical surgeries, but precision location of the entry site, and reliable and simple closure of the site after surgery each present novel problems and require new approaches. We present herein an improved technology for such control.